To assess the influence of baseline choroidal neovascularization (CNV) features on visual change and fluid resolution following anti-vascular endothelial growth factor (anti-VEGF) treatment of eyes with neovascular age-related macular degeneration (nAMD).
Post hoc analysis of 52-week data from the phase 3 VIEW 1 and VIEW 2 clinical trials.
1804 patients with nAMD.
Integrated data from VIEW 1 and 2 of 1804 eyes receiving intravitreal aflibercept injections (IAI) 2 mg every 4 weeks, IAI 2 mg every 8 weeks after 3 initial monthly doses, and ranibizumab every 4 weeks with documented baseline CNV type, total area, and leakage area were analyzed. Time to an event and cumulative incidence were evaluated by Kaplan-Meier analysis and relative risks were estimated using proportional hazards analysis.
Cumulative incidence of time to first sustained vision gain of ≥15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, vision loss of >5 ETDRS letters from baseline as well as first sustained absence of retinal fluid and intraretinal fluid as evaluated by optical coherence tomography with respect to CNV type, total CNV, and leakage area.
Eyes with predominantly classic CNV (mean best-corrected visual acuity [BCVA]: 48.2 letters at baseline) showed a higher incidence rate of first sustained gain of ≥15 letters than eyes with occult CNV (mean BCVA: 57.9 letters at baseline, P < 0.01). Eyes with occult CNV at baseline showed higher incidence rates of first sustained absence of retinal fluid and of intraretinal fluid than eyes with predominantly classic CNV (both P < 0.01). With increasing baseline CNV total area and leakage area, the incidence rate of first sustained gain of ≥15 letters decreased. Although baseline CNV total area did not have an effect, increasing baseline CNV leakage area (per 10 mm) was associated with a decreased incidence rate of sustained absence of retinal fluid and of intraretinal fluid (both P < 0.05).
This post hoc analysis provides additional evidence for the role of baseline CNV features (CNV type, total area, and leakage area) in influencing visual and anatomic outcomes in eyes with nAMD following anti-VEGF treatment.

Copyright © 2020. Published by Elsevier Inc.

References

PubMed